NRP-1和CXCR4对卵巢子宫内膜异位囊肿患者 妊娠结局的预测价值

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中图分类号：R711.71 文献标志码：A DOI：10.11958/20252959

Abstract： ObjectiveTo explore the expresion levels of serum neuropilin-1（NRP-1）and C-X-C motif chemokine receptor 4（CXCR4） in patients with ovarian endometriosis cysts （OEC）andtheir predictive value for pregnancyoutcome.

MethodsA totalof 136 OEC patients were includedas the study groupand were divided into the pregnancy group （84 cases）and the non-pregnancygroup （52cases）basedon whether theywere pregnant during follow-upperiod.Additionaly， 136healthy maried women of reproductive age undergoing physical examinations atour hospital during the same period wereselectedasthecontrolgroup.MultivariateLogisticregresionanalysis wasused toidentifyfactors influencing nonpregnancy in OEC patients.Receiver operating characteristic （ROC） curves were used to evaluate the predictive value of serum NRP-1and CXCR4 for pregnancy outcome.Decision curve analysis （DCA）was performed to determine the predictive performance of combined detection for non-pregnancy，and calibration curves were drawn toasssstheconsistencyof the model.ResultsTheserum levelsof vascular endothelial growth factor（VEGF），NRP-1and CXCR4 were higher in the study group compared to those of the control group （ P<0.05 ）. In the non-pregnant group，age and serum levels of VEGF， NRP-1 and CXCR4 were higher compared to those of the pregnant group （ P<0.05 ）. The elevated levels of NRP-1，CXCR4 and VEGF were risk factors for non-pregnancy in patients aged ⩾ 35years（ P<0.05 ）.The area under the curve （AUC）of serum NRP-1 and CXCR4 alone and in combination for predicting pregnancyoutcome was O.764，0.776 and0.870， respectively.The combination of the two was superior to their individual predictions （ P<0.05 ）. The DCA results showed that when the high-risk threshold was betweenO.14andO.91，thenetbenefitrateofjointpredictionofpregnancyoutcome was better than that of individual prediction. In addition，H-L test showed χ2 =7.032， P =0.714， indicating good consistency. ConclusionOEC patients have elevated serum levelsof NRP-1 and CXCR4， which are related to pregnancy outcome. Earlydetectioncanasist inclinically predicting patientpregnancyoutcome，andthe predictive valueishigher when tested in combination.

Key Words： endometriosis; ovarian cysts; pregnancy outcome; neuropilin-1; receptors， CXCR4; ovarian endometriosis cyst

子宫内膜异位症（EMT）是指子宫内膜间质组织和腺体异常生长于子宫腔外的身体其他部位，除导致盆腔粘连、慢性盆腔炎、输卵管伞拾卵和精子运输功能受损外，还会影响患者的卵巢功能，降低精子在子宫中的存活率，影响受孕[1]。（剩余10059字）